Mark Thielenhaus

Primary specialty

Religious Nonmedical PractitionerTaxonomy code 374K00000X

Practice address

622 N Sacramento St
Lodi, CA 95240-1256

Phone

(209) 367-9560

NPI assigned

Jul 31, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1396574877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 W LOCKEFORD ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952401946",
            "telephone_number": "209-369-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 N SACRAMENTO ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952401256",
            "telephone_number": "209-367-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIELENHAUS",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374K00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bowen James Terra, DPT, PT
• Daniel W. Terry Jr., MD
• Koleen Khale Testado
• Cha Choukao Thao, D.O.
• Arvinder Kaur Thiara, M.D.
• Sharon Marie Thomason
• Melissa Thorbjornsen, RN, BSN, IBCLC
• Thrifty Payless Inc
• Angelica Em Tindle
• Banesa Tinoco

• Religious Nonmedical Practitioner in Lodi, CA
• Providers in Lodi, CA by specialty
• Religious Nonmedical Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.