Active NPI
Simone Washington
- Home Modifications Contractor
- Rialto, CA
National Provider Identifier
1396161923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- License
- 366423954
- Practice address
- 2235 N Arrowhead Ave
Rialto, CA 92377-4564 - Phone
- (909) 562-4101
- NPI assigned
- Mar 6, 2014
- Last updated
- Mar 6, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | 366423954 | CA | Primary |
Addresses
Primary practice location
2235 N Arrowhead Ave
Rialto, CA 92377-4564
Mailing address
2235 North Arrowhead Ave.
Rialto, N/A 92377
UM
Phone (909) 562-4101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 366423954 | CA | MD | Home Modifications Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394064000000",
"number": "1396161923",
"addresses": [
{
"country_code": "UM",
"country_name": "United States Minor Outlying Islands",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "2235 NORTH ARROWHEAD AVE.",
"city": "RIALTO",
"state": "N/A",
"postal_code": "92377",
"telephone_number": "909-562-4101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2235 N ARROWHEAD AVE",
"city": "RIALTO",
"state": "CA",
"postal_code": "923774564",
"telephone_number": "909-562-4101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASHINGTON",
"first_name": "SIMONE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-06",
"last_updated": "2014-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": "CA",
"license": "366423954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rialto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.