Pacific Standard Physical Therapy, Incorporated

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PACIFIC STANDARD PHYSICAL THERAPY, INCORPORATED

Practice address

508 Webster St
Petaluma, CA 94952-2456

Phone

(480) 202-3669

NPI assigned

Aug 7, 2022

Last updated

Sep 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justin Lalonde, DPTNPI 1629584263

Title

Owner/Physical Therapist

Phone

(480) 202-3669

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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.

• Justin Brady Lalonde, PT

  • Physical Therapist
  • Petaluma, CA
  • NPI 1629584263
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1659830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1164159380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 WEBSTER ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522456",
            "telephone_number": "480-202-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 WEBSTER ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522456",
            "telephone_number": "480-202-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC STANDARD PHYSICAL THERAPY, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-07",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "LALONDE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "480-202-3669",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "pacificstandardpt@gmail.com",
            "affiliation": "N",
            "address_1": "5540 Brunswick Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921201831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bradley Kimball Osgood, D.C.
• Farid Osman, MD
• Robert I Ostroff, M.D.
• Pacific Advanced Surgical Services
• Pacific Restorative Center
• Berenice Padilla-Perez
• Laura A Pajari
• Jesebel Amelia Palacios Lopez
• Lynne Dee Palma, ARNP
• Hope Palmer

• Physical Therapy Clinic/Center in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.