Individual provider Active NPI

Bonnie M. Cardenas, PT

  • Physical Therapist
  • Encino, CA
National Provider Identifier
1053384024
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6807 Issued in CA
Practice address
5359 Balboa Blvd # a
Encino, CA 91316-2803
Phone
(818) 506-7821
Fax
(818) 506-6722
NPI assigned
Feb 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 PT6807 CA Primary

Addresses

Primary practice location

5359 Balboa Blvd # a
Encino, CA 91316-2803

Mailing address

4924 Balboa Blvd
# 475
Encino, CA 91316-3402
Phone (818) 506-7821

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

LicenseStateTypeSpecialty
6807CAMDOptometrist
PT6807CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Specialists, Inc Physical Therapist CurrentSince Nov 18, 2020 Accepting new patients

Locations

5359 Balboa Blvd
Ste A
Encino, CA 91316
Phone (818) 506-7821

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053384024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4924 BALBOA BLVD",
            "address_2": "# 475",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163402",
            "telephone_number": "818-506-7821",
            "fax_number": "818-506-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5359 BALBOA BLVD # A",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162803",
            "telephone_number": "818-506-7821",
            "fax_number": "818-506-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDENAS",
        "first_name": "BONNIE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT6807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.