Genesis J Dade, ATC

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1222 Lavendar Way
Corona, CA 92882-7333

Phone

(951) 665-7256

NPI assigned

Jul 12, 2022

Last updated

Jul 12, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1669106126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 LAVENDAR WAY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928827333",
            "telephone_number": "951-665-7256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 LAVENDAR WAY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928827333",
            "telephone_number": "951-665-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADE",
        "first_name": "GENESIS",
        "middle_name": "J",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CA",
            "license": "E151905",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Robert Cyr, MFT
• Michele L. Cyr, LCSW
• D.R. Optometry
• Yvonne Ramona D'Sylva, M.D.
• Tasneem Dadabhoy, ASW
• Yen Ngoc Dahl, WHNP-BC, CNM
• Charles Dai, M.D.
• Chenxinxin Dai
• Linly Dai
• Richard R Dalessandro, MD

• Student in an Organized Health Care Education/Training Program in Corona, CA
• Providers in Corona, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.