Juan Cantillo Correa, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

52134 Issued in CA

Practice address

2019 W Avenue K
Lancaster, CA 93536-5217

Phone

(818) 990-9535

NPI assigned

Nov 7, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Vargo Physical Therapy, Inc

  • Physical Therapist
  • Lancaster, CA
  • NPI 1194395301
  NPD
• Vargo Physical Therapy, Inc.

  • Physical Therapist
  • Santa Clarita, CA
  • NPI 1811910797
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1003524224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25115 AVENUE STANFORD STE B135",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913551290",
            "telephone_number": "661-250-9940",
            "fax_number": "661-250-9959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 W AVENUE K",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935365217",
            "telephone_number": "818-990-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTILLO CORREA",
        "first_name": "JUAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "52134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kanika Shanta Cannon
• Laneice R Cannon
• Kaileigh D Cano
• Lisa Roberta Cano
• Celeste Antoinette Cantarero, NONE
• Vivian Cao, PHARM.D
• Taylor Capone, CCCSLP
• Melissa Guadalupe Capristo
• Michael Caravella
• Griselda Carbajal

• Physical Therapy Assistant in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.