Individual provider Active NPI

Nicolas Takeyoshi Kiyohara, PT, DPT

  • Physical Therapist
  • Tustin, CA
National Provider Identifier
1023938685
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
310335 Issued in CA
Practice address
13931 Carroll Way Ste B
Tustin, CA 92780-1861
Phone
(714) 988-8120
Fax
(714) 988-8119
NPI assigned
Jul 15, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 310335 CA Primary

Addresses

Primary practice location

13931 Carroll Way Ste B
Tustin, CA 92780-1861

Mailing address

3230 E Imperial Hwy Ste 100
Brea, CA 92821-6735
Phone (714) 988-8110

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

NPI Registry JSON

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

{
    "created_epoch": "1784073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1023938685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 E IMPERIAL HWY STE 100",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216735",
            "telephone_number": "714-988-8110",
            "fax_number": "714-988-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13931 CARROLL WAY STE B",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801861",
            "telephone_number": "714-988-8120",
            "fax_number": "714-988-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIYOHARA",
        "first_name": "NICOLAS",
        "middle_name": "TAKEYOSHI",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-15",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "310335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.