Active NPI
Dana Walker, CMF
- Mastectomy Fitter
- Rancho Cucamonga, CA
National Provider Identifier
1679106926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mastectomy Fitter
- License
- C53363
- Practice address
- 9033 Baseline Rd Ste C
Rancho Cucamonga, CA 91730-1214 - Phone
- (951) 790-3039
- NPI assigned
- Feb 14, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mastectomy Fitter | 224900000X | C53363 | CA | Primary |
Addresses
Primary practice location
9033 Baseline Rd Ste C
Rancho Cucamonga, CA 91730-1214
Mailing address
6886 Riverrun CT
Eastvale, CA 91752-3437
Phone (951) 371-1449
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 |
|---|---|---|---|
| C53363 | CA | MD | Mastectomy Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cinderella'S Closet Your Specialty Lingerie Boutique | Mastectomy Fitter | Current | Accepting new patients |
Locations
9033 Base Line Rd
Ste C
Rancho Cucamonga, CA 91730
Phone (909) 989-2563
9651 Business Center Dr
Ste B
Rancho Cucamonga, CA 91730
Phone (951) 758-8827
Organizations & group practices 1
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.
-
- Mastectomy Fitter
- Rancho Cucamonga, CA
- NPI 1386277002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581638400000",
"number": "1679106926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6886 RIVERRUN CT",
"city": "EASTVALE",
"state": "CA",
"postal_code": "917523437",
"telephone_number": "951-371-1449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9033 BASELINE RD STE C",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917301214",
"telephone_number": "951-790-3039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "DANA",
"credential": "CMF",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-14",
"last_updated": "2020-02-14",
"certification_date": "2020-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "224900000X",
"taxonomy_group": "",
"desc": "Mastectomy Fitter",
"state": "CA",
"license": "C53363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.