Memory Lane LLC
Memory Lane LLC is an Adult Companion in Vista, California. Registered with an NPI since 2025.
- In the registry since
- 2025
- Specialties on file
- 2
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1642 Lisa AveVista, CA 92084-3054
Phone: (760) 536-3139
Fax: (760) 806-3582
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Personal Care Attendant (primary) | Taxonomy 3747P1801X |
|---|---|
| Adult Companion | Taxonomy 372600000X |
Record details
| NPI number | 1194690800 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Amy Wombolt — Owner · (760) 445-3639 |
| NPI enumerated | October 10, 2025 |
| Last updated in NPPES | October 10, 2025 |
| Certification date | October 10, 2025 |
| Mailing address | 1642 Lisa Ave, Vista, CA 92084-3054 |