Active NPI
Tricia Shelton, P.T.A
- Physical Therapy Assistant
- Lake Forest, CA
National Provider Identifier
1023028594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 4822
- Practice address
- 22741 Lambert St
Lake Forest, CA 92630-1617 - Phone
- (949) 581-3839
- Fax
- (949) 454-6763
- NPI assigned
- Aug 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 4822 | CA | Primary |
Addresses
Primary practice location
22741 Lambert St
Lake Forest, CA 92630-1617
Mailing address
20 Bienvenue Dr
Foothill Ranch, CA 92610-2334
Phone (949) 454-8061
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4822 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023028594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 BIENVENUE DR",
"city": "FOOTHILL RANCH",
"state": "CA",
"postal_code": "926102334",
"telephone_number": "949-454-8061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22741 LAMBERT ST",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926301617",
"telephone_number": "949-581-3839",
"fax_number": "949-454-6763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELTON",
"first_name": "TRICIA",
"credential": "P.T.A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "4822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Forest, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.