Individual provider Active NPI

Dana Walker, CMF

  • Mastectomy Fitter
  • Rancho Cucamonga, CA
National Provider Identifier
1679106926
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mastectomy FitterTaxonomy code 224900000X
License
C53363 Issued in CA
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

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
C53363CAMDMastectomy Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Cinderella'S Closet Your Specialty Lingerie Boutique Mastectomy Fitter CurrentSince Feb 16, 2020 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.

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.

Verify at the official NPI Registry.