Raven Amber Biondo
Rehabilitation Practitioner in San Diego, CA. Individual provider (NPI-1).
NPI number1104724558
StatusActive
Last updated in NPPESOct 28, 2026
Details
- NPI
- 1104724558
- Entity type
- Individual (NPI-1)
- Name
- Raven Amber Biondo
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 27, 2026
- Certification date
- Oct 28, 2026
- Last updated
- Oct 28, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | – | CA | Yes |
Practice location
1011 Camino Del Rio S Ste 300San Diego, CA 92108-3567
Phone 619-287-8225 · Fax 619-393-0386
Mailing address
1011 Camino Del Rio S Ste 300San Diego, CA 92108-3567
Phone 619-287-8225 · Fax 619-393-0386
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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