NPIMap

Organization Active NPI

Prunedale Physical Therapy

  • Specialist
  • Prunedale, CA
National Provider Identifier
1053492207
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PRUNEDALE PHYSICAL THERAPY
Practice address
17823 Countryside CT
Prunedale, CA 93907-8804
Phone
(831) 663-8819
Fax
(831) 663-5376
NPI assigned
Oct 17, 2006
Last updated
Nov 6, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Authorized official

Name
Mrs. Yara Miramontes
Title
Office Manager
Phone
(831) 663-8819

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

17823 Countryside CT
Prunedale, CA 93907-8804

Mailing address

17823 Countryside CT
Prunedale, CA 93907-8804
Phone (831) 663-8819

National Provider Directory

National Provider Directory

Locations

17823 Countryside Ct
Prunedale, CA 93907
Phone (831) 663-8818

321 E Romie Ln
Ste B
Salinas, CA 93901
Phone (408) 757-6834

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1053492207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17823 COUNTRYSIDE CT",
            "city": "PRUNEDALE",
            "state": "CA",
            "postal_code": "939078804",
            "telephone_number": "831-663-8819",
            "fax_number": "831-663-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17823 COUNTRYSIDE CT",
            "city": "PRUNEDALE",
            "state": "CA",
            "postal_code": "939078804",
            "telephone_number": "831-663-8819",
            "fax_number": "831-663-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUNEDALE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "MIRAMONTES",
        "authorized_official_first_name": "YARA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "831-663-8819",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prunedale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.

Verify at the official NPI Registry.