Individual provider Active NPI

Tannya Heinz

  • Clinic/Center
  • Redlands, CA
National Provider Identifier
1760146658
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Practice address
1235 Indiana CT Ste 107
Redlands, CA 92374-4540
Phone
(909) 566-3358
Fax
(909) 757-6400
NPI assigned
Oct 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X CA Primary

Addresses

Primary practice location

1235 Indiana CT Ste 107
Redlands, CA 92374-4540

Mailing address

1235 Indiana CT Ste 107
Redlands, CA 92374-4540
Phone (909) 566-3358

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Redlands Direct

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

Practice roles

OrganizationSpecialtyStatusNew patients
Starlight Therapy Center Inc CurrentSince Oct 31, 2021 Accepting new patients

Locations

1235 Indiana Ct
Ste 107
Redlands, CA 92374
Phone (909) 566-3358

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": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1760146658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 INDIANA CT STE 107",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744540",
            "telephone_number": "909-566-3358",
            "fax_number": "909-757-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 INDIANA CT STE 107",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744540",
            "telephone_number": "909-566-3358",
            "fax_number": "909-757-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINZ",
        "first_name": "TANNYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Redlands",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1235 Indiana Ct Ste 107",
            "city": "Redlands",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923744540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.