Organization Active NPI

Conejo Valley Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Thousand Oaks, CA
National Provider Identifier
1063745842
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT14444 Issued in CA
Legal business name
CONEJO VALLEY PHYSICAL THERAPY, INC
Practice address
90 E Thousand Oaks Blvd Ste 200
Thousand Oaks, CA 91360-5761
Phone
(805) 497-9300
Fax
(805) 497-9311
NPI assigned
Sep 11, 2009
Last updated
May 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Authorized official

Name
Jennifer Lee Vonarb, P.T.NPI 1437221199
Title
Owner
Phone
(805) 497-9300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT14444 CA Primary

Addresses

Primary practice location

90 E Thousand Oaks Blvd Ste 200
Thousand Oaks, CA 91360-5761

Mailing address

90 E Thousand Oaks Blvd Ste 200
Thousand Oaks, CA 91360-5761
Phone (805) 497-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110725000199 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5294903977 Receives reassigned benefits from 4 practitioners
Practice locations: Camarillo, CA; Thousand Oaks, CA
O20231229001513 CA DME Supplier - Independently-Practicing Physical Therapist 5294903977 Practice locations: Thousand Oaks, CA

National Provider Directory

National Provider Directory

Locations

90 E Thousand Oaks Blvd
Ste 200
Thousand Oaks, CA 91360
Phone (805) 341-7110

Practitioners & affiliated clinicians

Practitioners 5

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": "1252627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305676800000",
    "number": "1063745842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 E THOUSAND OAKS BLVD STE 200",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605761",
            "telephone_number": "805-497-9300",
            "fax_number": "805-497-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 E THOUSAND OAKS BLVD STE 200",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605761",
            "telephone_number": "805-497-9300",
            "fax_number": "805-497-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONEJO VALLEY PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-11",
        "last_updated": "2011-05-18",
        "status": "A",
        "authorized_official_last_name": "VONARB",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-497-9300",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT14444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.