Individual provider Active NPI

Daniel W Lane, D.O.

  • Psychiatry Physician
  • Redlands, CA
National Provider Identifier
1619174067
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A10534 Issued in CA
Practice address
1809 W Redlands Blvd
Redlands, CA 92373-8054
Phone
(909) 335-3026
Fax
(909) 335-3167
NPI assigned
Jun 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 20A10534 CA Primary

Addresses

Primary practice location

1809 W Redlands Blvd
Redlands, CA 92373-8054

Mailing address

1809 W Redlands Blvd
Redlands, CA 92373-8054
Phone (909) 335-3026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111220000177 CA Practitioner - Psychiatry 0345416434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Foothills Psychological Services IncGroup PAC ID 9436157534, 37 clinicians

Practice addresses (Care Compare)

954 W Foothill Blvd
Suite a
Upland, CA 91786-3782
Phone (909) 946-4222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Psychological Services, Inc. Psychiatry CurrentSince Dec 1, 2015 Accepting new patients
Health Service Alliance Past Accepting new patients

Locations

13193 Central Ave
Ste 100
Chino, CA 91710
Phone (909) 464-9675

13193 Central Ave
Ste 200
Chino, CA 91710
Phone (909) 902-9111

5050 San Bernardino St
Montclair, CA 91763
Phone (909) 281-5800

10832 Laurel St
Ste 102
Rancho Cucamonga, CA 91730
Phone (909) 987-1997

10837 Laurel St
Ste 204
Rancho Cucamonga, CA 91730
Phone (310) 246-0702

9089 Base Line Rd
Ste 100
Rch Cucamonga, CA 91730
Phone (909) 483-0505

954 W Foothill Blvd
Ste A
Upland, CA 91786
Phone (909) 946-4222

600 N Euclid Ave
Ste 204
Upland, CA 91786
Phone (909) 379-1513

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1619174067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 W REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738054",
            "telephone_number": "909-335-3026",
            "fax_number": "909-335-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 W REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738054",
            "telephone_number": "909-335-3026",
            "fax_number": "909-335-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "DANIEL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A10534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.