Active NPI
Kylie Faildo, DPT
- Physical Therapist
- Huntington Beach, CA
National Provider Identifier
1023748910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT302142
- Practice address
- 19531 Beach Blvd
Huntington Beach, CA 92648-2902 - Phone
- (714) 960-7995
- NPI assigned
- Jun 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 Therapist | 225100000X | PT302142 | CA | Primary |
Addresses
Primary practice location
19531 Beach Blvd
Huntington Beach, CA 92648-2902
Mailing address
19531 Beach Blvd
Huntington Beach, CA 92648-2902
Phone (714) 960-7995
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT302142 | Other | CA | PHYSICAL THERAPY BOARD OF CALIFORNIA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT302142 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655164800000",
"number": "1023748910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19531 BEACH BLVD",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926482902",
"telephone_number": "714-960-7995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19531 BEACH BLVD",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926482902",
"telephone_number": "714-960-7995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAILDO",
"first_name": "KYLIE",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-14",
"last_updated": "2022-06-14",
"certification_date": "2022-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT302142",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPY BOARD OF CALIFORNIA",
"identifier": "PT302142",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.