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MEMORY LANE LLC
NPI 1194690800
Technician - Personal Care Attendant in Vista, CA

Active since October 10, 2025
1642 LISA AVE, VISTA, CA 92084(760) 536-3139(760) 806-3582 Get Directions Write a Review

NPPES record last updated: October 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Memory Lane Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEMORY LANE LLC (NPI 1194690800) is a healthcare organization registered as a personal care attendant in Vista, California and active in the NPI registry since October 2025. The organization lists Amy Michelle Wombolt, Owner, as its authorized official.

NPPES Registry Identity

NPI1194690800
Entity TypeOrganization
Primary Taxonomy3747P1801X
Legal Business NameMEMORY LANE LLC
Location Address1642 LISA AVEVista, CA 92084-3054
Mailing Address1642 Lisa AveVista, CA 92084-3054 · (760) 445-3639 · Fax (760) 806-3582
Phone(760) 536-3139
Fax(760) 806-3582
Organization SubpartNo
Authorized OfficialAmy Michelle WomboltOwner · (760) 445-3639
Enumeration DateOctober 10, 2025
NPPES CertifiedOctober 10, 2025
✔ NPI 1194690800 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyTechnician · Personal Care AttendantNursing Service Related Providers
Taxonomy Code3747P1801X
Definition
An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards
Also ListedAdult CompanionTaxonomy 372600000X
1642 LISA AVE, Vista, CA 92084
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEMORY LANE LLC
In Home Supportive Care
1642 LISA AVE
VISTA, CA 92084
San Diego County (760) 445-3639

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Memory Lane LLC's NPI number?

The NPI number for Memory Lane LLC is 1194690800. It was assigned to this organization in the NPPES registry on October 10, 2025.

Where is Memory Lane LLC located?

Memory Lane LLC is located at 1642 Lisa Ave, Vista, CA 92084. The listed phone number is (760) 536-3139.

What is Memory Lane LLC's specialty?

The primary specialty registered for this NPI is Technician, specializing in Personal Care Attendant, with taxonomy code 3747P1801X.

When was this NPI record last updated?

The NPPES record for Memory Lane LLC was last updated on October 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.