Rehabulous Physical Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT37451 Issued in CA

Legal business name

REHABULOUS PHYSICAL THERAPY, INC.

Practice address

12526 Riverside Drive
Valley Village, CA 91607

Phone

(650) 455-0605

NPI assigned

Apr 9, 2018

Organization subpart

No

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

Authorized official

Name

Miss Rossana Avila, PT, DPT

Title

Ceo/Doctor of Physical Therapy

Phone

(650) 455-0605

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523232000000",
    "number": "1043717812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11333 MOORPARK ST.",
            "address_2": "SUITE 57",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "91602",
            "telephone_number": "650-455-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12526 RIVERSIDE DRIVE",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "91607",
            "telephone_number": "650-455-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABULOUS PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-09",
        "status": "A",
        "authorized_official_last_name": "AVILA",
        "authorized_official_first_name": "ROSSANA",
        "authorized_official_title_or_position": "CEO/DOCTOR OF PHYSICAL THERAPY",
        "authorized_official_telephone_number": "650-455-0605",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT37451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; 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.