Organization Active NPI

Braintek Institute

  • Mechanotherapist
  • San Diego, CA
National Provider Identifier
1376987701
Registry record updated Jun 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
2457 BCN Issued in CA
Legal business name
BRAINTEK INSTITUTE
Practice address
3978 Sorrento Valley Blvd
Suite 310
San Diego, CA 92121-1436
Phone
(858) 735-4888
Fax
(858) 385-0222
NPI assigned
Apr 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2013

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

Authorized official

Name
Mr. Dennis Maness, PH.D.NPI 1336583764
Title
Owner
Phone
(858) 735-4888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 2457 BCN CA
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 2457 BCN CA
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 2457 BCN CA
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X 2457 BCN CA
MechanotherapistGroup: 193200000X MULTI-SPECIALTY GROUP 172M00000X 2457 BCN CA Primary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 2457 BCN CA
NaturopathGroup: 193200000X MULTI-SPECIALTY GROUP 175F00000X 2457 BCN CA

Addresses

Primary practice location

3978 Sorrento Valley Blvd
Suite 310
San Diego, CA 92121-1436

Mailing address

3978 Sorrento Valley Blvd
Suite 310
San Diego, CA 92121-1436
Phone (858) 735-4888

Other identifiers 1

IdentifierTypeStateIssuer
2457 BCNOtherCABOARD CERTIFIED NEUROTHERAPIST

National Provider Directory

National Provider Directory

Locations

3978 Sorrento Valley Blvd
Ste 310
San Diego, CA 92121
Phone (858) 735-4888

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370476800000",
    "number": "1376987701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3978 SORRENTO VALLEY BLVD",
            "address_2": "SUITE 310",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211436",
            "telephone_number": "858-735-4888",
            "fax_number": "858-385-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3978 SORRENTO VALLEY BLVD",
            "address_2": "SUITE 310",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211436",
            "telephone_number": "858-735-4888",
            "fax_number": "858-385-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAINTEK INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-29",
        "last_updated": "2013-06-06",
        "status": "A",
        "authorized_official_last_name": "MANESS",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-735-4888",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "2457 BCN",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "2457 BCN",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "2457 BCN",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "2457 BCN",
            "primary": false
        },
        {
            "code": "172M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Mechanotherapist",
            "state": "CA",
            "license": "2457 BCN",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "2457 BCN",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "CA",
            "license": "2457 BCN",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD CERTIFIED NEUROTHERAPIST",
            "identifier": "2457 BCN",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; 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.