Provider Demographics
NPI:1952196743
Name:RESEDA PROSTHETICS, INC.
Entity type:Organization
Organization Name:RESEDA PROSTHETICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARACELI
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-993-5441
Mailing Address - Street 1:18441 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-3309
Mailing Address - Country:US
Mailing Address - Phone:818-996-5441
Mailing Address - Fax:818-993-4311
Practice Address - Street 1:2000 OUTLET CENTER DR STE 222
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-0609
Practice Address - Country:US
Practice Address - Phone:805-725-0194
Practice Address - Fax:805-725-0198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment